We are now having an unprecedented opportunity for change, but Robert H.
Insomnia, an extreme case discussion of the inability to fall and stay asleep; Gabapentin seems to help. (It is a drug ordinarily used in the treatment of epilepsy, and neuropathic pain.) Abstract
Achieving patient-centered care is difficult, but essential; since paternalism is out, the patient has a greater role to play. The editorial, "Patient-Centered Care; What Is the Best Measuring Stick?" by Drs.
Flu or Common Cold? JB wites: "I am really feeling sick and my temp is 100o even with two ibuprofen. Can you call in a script for Z pack and some cough medicine with codeine?" On Jan 16, 2011, at 7:39 AM Response: It's only because I care that I won't treat you without a proper examination by a qualified health care practitioner any more than I do my wife or grandkids (unless I have to).
Autism Spectrum Disorders (ASDs) Understanding diseases that affect development of the brain, e.g. autism and schizophrenia is challenging because of the complexity of such diseases and the difficulty of studying developmental processes in human tissues. First, Definitions: The following provides standardized criteria to help diagnose ASD; it is from the American Psychiatric Association's Diagnostic and Statistical Manual-IV, Text Revision (DSM-IV-TR).
Curative, Preventive and Now Precision Medicine Will Consider Individual Variability
The modus operandi in managed care is that one cannot manage what one does not measure. Outcome Measurement will be telling; it will be the final arbiter. Managed Care is a system of health care management that is intended to reduce inappropriate and/or unnecessary health care expenditures by aligning economic incentives for both practitioners and patients so that both understand their options and select care that provides optimal value.*
$600-$850 billion/yr in the U.S. is spent on low value or inappropriate services
"Perhaps the best cure for the fear of death is to reflect that life has a beginning as well as an end. There was a time when you were not: that gives us no concern. Why then should it trouble us that a time will come when we shall cease to be? To die is only to be as we were before we were born." – William Hazlitt, essayist (1778-1830) Quote from The Conversation Project by Ellen Goodman and Others
Pet Peeves: antibiotics for short term, ostensibly viral diseases -- bronchitis, sinusitis, nasopharyngitis or otitis media; half of abdominal CT scans or the half of back MRIs that show bulging disks on persons sans back pain. Whose failure is it to not control costs? Ref.: Chen P. "The Doctor’s Failure to Cut Costs" NY Times 3/3/2010 (Extracts are for discussion purposes, only) In an editorial in The New England Journal of Medicine, Dr.